Preliminary experience with a new cytology brush in EUS-guided FNA

Background Despite the high diagnostic yield of EUS-guided FNA, room for technical improvements remains. Recently, the EchoBrush (Cook Endoscopy, Winston-Salem, NC), a disposable cytologic brush, was introduced to the market. To date, only 1 study, limited to 10 pancreatic cyst cases, using this device has been published. Objective To assess the diagnostic yield of the EchoBrush in a cohort of consecutive patients, irrespective of the target lesion. Design Case series. Setting Tertiary care university hospital (Molinette Hospital, Turin, Italy). Patients Thirty-nine consecutive patients (12 with solid pancreatic masses, 12 with pancreatic cysts, 7 with enlarged lymph nodes, and 8 with submucosal masses) were enrolled. Interventions The material collected with the EchoBrush and with a standard FNA needle was double-blind evaluated by 2 cytopathologists. Main Outcome Measurements Adequacy of the sample and sensitivity and specificity of the EchoBrush method. Results Adequate material for cytologic analysis was collected in 17 of 39 patients (43.6%) with a single pass of the EchoBrush. Results were better for pancreatic lesions (for solid and cystic lesions, the adequacy was 58.3% and 50%, respectively); adequacy was low (28.6% and 25%, respectively) for lymph nodes and submucosal masses. The overall sensitivity and specificity were 57.9% and 31.2%, respectively. There were no adverse events with the procedure. Limitation Preliminary study. Conclusions This report suggests that the EchoBrush may provide adequate cellularity to diagnose solid and cystic pancreatic lesions. More extensive studies are needed to compare the EchoBrush and standard needles.